Internal Medicine Section
Evaluation of Subtle Left Ventricular Systolic Abnormalities in Adult Patients with Hypertrophic Cardiomyopathy
Ranjan Shetty1, Jyothi Samanth2, Krishnanand Nayak3, Arohi Sarang4, Ashok Thakkar5
ABSTRACT Background: Hypertrophic cardiomyopathy (HCM), an autosomal dominant disorder due to mutation of genes encoding sarcomeric proteins, leads to left ventricular diastolic dysfunction. Recently, the research in this area suggests that systolic dysfunction exists in the patients with HCM even though traditional measures of systolic dysfunction are normal. So, we carried out this study to determine global systolic dysfunction in patients with HCM. Materials and Methods: A total of 18 patients, diagnosed with HCM according to echocardiography parameters, that is thickness of interventricular septum/posterior wall thickness >1.3 or hypertrophy involving apex only with or without left ventricular outflow tract obstruction, were included in the study and were compared with normal age-matched controls. We measured torsion and strain imaging by 2-dimensional echocardiography as well as strain imaging by tissue Doppler echocardiography.
Result: The results of the study showed that there was considerable increased torsion in patients with HCM as compared to normal subjects (16.61±7.43 vs. 10.42±4.73, p=0.006). Tissue Doppler indices—systolic annular velocity (7.7±0.7 vs. 8.7±1.00, p=0.012) and lateral wall E/E’ (12.52±5.27 vs. 6.66±1.67, p1.3 with or without left ventricular outflow tract obstruction (LVOTO) or systolic anterior motion of mitral valve (SAM) or patients diagnosed with apical HCM. The patients having LVEF